Effects of single-dose preemptive intravenous ibuprofen on postoperative opioid consumption and acute pain after laparoscopic cholecystectomy.

BACKGROUND

Although studies involving intravenous (IV) ibuprofen are still limited, it has been shown to have a potential role in the treatment of postoperative pain. The primary objective of this study was to investigate the effects of preemptive IV ibuprofen on postoperative 24 hour opioid consumption and postoperative pain in patients undergoing laparoscopic cholecystectomy.

METHODS

Following ethical committee approval, 60 patients aged 18 to 65, American Society of Anesthesiology (ASA) I-II, and scheduled for laparoscopic cholecystectomy were included in this prospective, randomized, double-blinded study. Patients were randomly divided into 1 of 2 groups. The control group (n = 30) received 100 mL saline solution 30 minutes before surgery, while the ibuprofen group (n = 30) received 400 mg IV ibuprofen in 100 mL saline. The same general anesthesia protocol was applied in both groups, and all operations were performed by the same surgeon using the same technique. Postoperative analgesia was assessed using a visual analogue pain scale (VAS) with active and passive movements. Twenty-four hour postoperative fentanyl consumption with patient-controlled analgesia and additional analgesia requirements were recorded. Postoperative analgesia was established with 1000 mg paracetamol once every 6 hours and patient-controlled IV fentanyl.

RESULTS

Compared with the control group, VAS scores in the IV ibuprofen group were statistically lower at postoperative 30 minutes and 1, 2, 4, 8, 12, and 24 hours (P < 0.001). Twenty-four hour opioid consumption was statistically significantly higher in the control group compared to the ibuprofen group (553.00 ± 257.04 and 303.33 ± 132.08 μcq, respectively, P < 0.001). Additional analgesia use was statistically significantly higher in the control group than in the ibuprofen group (14/30 vs 5/30, respectively, P < 0.001). The rates of nausea and vomiting were higher in group control than in group ibuprofen (13/30 vs 5/30, respectively, P = 0.024). Other side-effects were similar between the groups.

CONCLUSION

A preemptive single dose of IV ibuprofen in laparoscopic cholecystectomy reduced postoperative opioid consumption in the 1st 24 hours by 45%. It generated lower pain scores in the postoperative period compared with placebo.